Differentiating moderate and severe depression using the Montgomery-Asberg Depression Rating Scale (MADRS)

Background: MADRS cut-off scores for moderate and severe depression were estimated in relation to the Hamilton Depression Rating Scale (HAMD(17)) and the Clinical Global Impressions Scale (CGI). Method: HAMD(17), MADRS, and CGI ratings from patients with major depression (DSM-IV) were analyzed (N = 85). Receiver operating characteristics (ROC) curves were applied. Results: Mean age was 51.4 +/- 14.5 years, 69% were female. Mean MADRS scores were 23.4 +/- 13.2, HAMD(17), MADRS, and CGI scores were highly correlated (r > 0.85; P < .0001). Best separation between moderate and severe depression according to CGI criteria was achieved with a MADRS score of 31 (sensitivity 93.5%, specificity 83.3%). Limitations: Studies to validate severity gradations including DSM-IV or ICD-10 diagnostic severity categories are recommended. Conclusions: Empirically based MADRS cut-off scores to separate moderate from severe depression on the basis of HAMD(17) and CGI severity ratings in patients with major depression were yielded. (C) 2002 Elsevier B.V. All rights reserved.